Individual
MISS MIRELLA VILLASUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1400 NW 12TH AVE, MIAMI, FL 33136-1003
(305) 689-5511
Mailing address
8455 NW 189TH LN, UNIT 1503, HIALEAH, FL 33015-7239
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
3401972
FL
Other
Enumeration date
11/28/2011
Last updated
11/28/2011
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